Who Is Eligible for 21st Century Coverage?

To qualify for a policy, you must:

  • Be under the age of 86.
  • Not be:
  1. Travelling against medical advice.
  2. Diagnosed with a terminal illness (life expectancy under 2 years).
  3. Diagnosed with or treated in the last 2 years for pancreatic, lung, brain, or liver cancer.
  4. Diagnosed with metastatic cancer (cancer that has spread).
  5. A recipient or awaiting an organ/bone marrow transplant (corneal transplant excluded).
  6. Diagnosed with congestive heart failure.
  7. On home oxygen in the past 12 months.
  8. In kidney dialysis.
  9. Residing in a nursing home or long-term care facility.

Plan Options Based on Age and Health

  1. Under 55:
    • Eligible for the Enhanced Plan (no medical declaration needed).
  2. Ages 55–85:
    • If you answer “No” to all medical questions, you’re eligible for the Enhanced Plan.
    • If you answer “Yes” to any medical question, you are only eligible for the Standard Plan.
  3. Age 86 or older:
    • Not eligible for any plan.

SECTION 5 – ELIGIBILITY

You are not eligible for coverage under this policy if:

  1. you are travelling against the advice of a physician;
  2. you have been diagnosed with a terminal illness with less than two (2) years to live;
  3. you have been diagnosed with or received treatment within the last two (2) years for pancreatic, lung, brain, or liver cancer;
  4. you have ever been diagnosed with any type of cancer that has spread from one part or organ of the body to another (metastatic cancer);
  5. you have had or are waiting for an organ or bone marrow transplant (excluding corneal transplant);
  6. you have ever been diagnosed with Congestive Heart Failure;
  7. you have been prescribed or used home oxygen in the last 12 months;
  8. you require kidney dialysis;
  9. you reside in a nursing home or long term care facility; and/or
  10. you are age 86 or older.

We reserve the right to decline any application.

One or more persons may be insured under one policy. However, the effective date and
expiry date must be identical for all applicants. Each applicant must pay their
appropriate individual premium unless family rates apply.

Be sure to review the waiting period definition to determine if there is any time that
you will not be reimbursed for expenses related to any sickness manifesting during that time.

The Enhanced Plan or The Standard Plan

If you are under age 55, the Enhanced Plan is available to you if you satisfy the Eligibility requirements and pay the appropriate premium.
If you are age 55 to 85, the Enhanced Plan is available to you if you satisfy the Eligibility requirements, truthfully and accurately answer “No” to all questions on the Medical Declaration and pay the appropriate premium.
If you are age 55 to 85 and you answer “Yes” to any question on the Medical Declaration, you are not eligible for the Enhanced Plan, but the Standard Plan is available to you under this policy if you satisfy the Eligibility requirements and pay the appropriate premium.
If you are under age 86, the Standard Plan is available to you, without the completion of the Medical Declaration, if you satisfy the Eligibility requirements and pay the appropriate premium.
Applicants age 86 and over or applicants of any age who do not satisfy the Eligibility requirements are not eligible to purchase this policy.

21st Century Insurance – What’s Not Covered

Medical & Pre-existing Conditions

    1. Standard Plan: No coverage for any pre-existing condition.
    2. Enhanced Plan: No coverage for unstable conditions, even if pre-existing.
    3. Any sickness, disease, or symptoms that:
      • Appeared during the waiting period
      • Were expected, planned for, or advised against prior to travel
      • Recurred or required treatment during a return home (for multi-entry visa holders)
    4. Expenses tied to false information on your application.
Excluded Treatments or Services
  1. Certain cardiovascular procedures (e.g., angioplasty) unless pre-approved.
  2. Self-inflicted injuries unless due to mental illness and medically documented.
  3. Injury from illegal acts or criminal activity.
  4. Ignoring prescribed treatment or medication non-compliance.
  5. Conditions tied to alcohol, drug, or intoxicant abuse.
  6. Minor mental or emotional disorders (unless hospitalization is required).
  7. Elective, cosmetic, investigative, chronic care, or rehabilitation.
  8. General health checkups, routine prescriptions, or maintenance of chronic conditions.
Activities Not Covered
  1. Accidents due to:
  • Mountain climbing with gear
  • Rock climbing, parachuting, hang-gliding
  • Professional sports, speed contests
  • Paid scuba diving/snorkeling (if it’s your occupation)
Pregnancy-Related Exclusions
  1. Pregnancy before the policy starts, routine prenatal/postnatal care, or complications
    9 weeks before/after due date.
  2. Medical care for babies born during your coverage.
  3. Treatment for children under 30 days old.
Location-Based Exclusions
  1. War or terrorism (outside Canada).
  2. Ongoing treatment started before the policy’s effective date or during the waiting period.
  3. Treatment outside Canada (if the emergency happened in Canada).
  4. Conditions linked to a country with a Canadian travel advisory.
  5. Conditions that arose during a coverage suspension (like a side-trip abroad).
Other Notable Exclusions
  1. Immigration medical assessments or follow-up care from those.
  2. If you’re advised to return home and you don’t, coverage ends.
  3. No ongoing care after an emergency is deemed resolved.
  4. Treatments covered under provincial healthcare.
  5. Failure to call the assistance center within 24 hours of hospitalization may reduce reimbursement by 20%.

GMS Travel Insurance – Key Exclusions

We will not reimburse you for insured services or pay an Accidental Death and Dismemberment claim and/or any other expenses directly or indirectly related to:
  1. i) any pre-existing condition if you are covered under the Standard Plan; or ii) any unstable condition if you are covered under the Enhanced Plan, paid the required premium and if you are age 55 to 85 you have completed the Medical Declaration.
  2. any sickness, disease or symptom that manifests before or during the waiting period even if related expenses are incurred after the waiting period.
  3. any sickness, disease, symptom, or injury:
    1. when you knew, prior to your effective date, that you would need or be required to seek treatment for that medical condition during your trip; and/or
    2. for which, prior to your effective date, it was reasonable to expect that you would need treatment during your trip; and/or
    3. for which future investigation or treatment was planned prior to your effective date; and/or
    4. which produced symptoms that would have caused an ordinarily prudent person to seek treatment in the 180 days prior to the effective date; and/or
    1. that had caused a physician to advise you not to travel; and/or
    2. that presented, recurred or for which treatment was received during any temporary return to your country of origin during the Coverage Period as is permitted only if you are a holder of a multiple-entry visa.
  2. any expenses or benefits if the information provided on your application for insurance is not truthful and accurate or you did not meet the eligibility requirements.
  3. cardiac catheterization, angioplasty and/or cardiovascular surgery including any associated diagnostic test(s) including but not limited to, magnetic resonance imaging (MRI), computerized axial tomography (CAT) scans, sonograms, ultrasounds or biopsies, or charges unless approved by the Assistance Centre prior to being performed, except in extreme circumstances where such procedures are performed on an emergency basis immediately upon admission to a hospital.
  4. your self-inflicted injuries, unless medical evidence establishes that the injuries are related to a mental health illness.
  5. any claim that results from or is related to your commission or attempted commission of a criminal offence or illegal act.
  6. any medical condition that is the result of you not following treatment as prescribed to you, including prescribed medication.
  7. any medical condition, including symptoms of withdrawal, arising from, or in any way related to, your chronic use of alcohol, drugs or other intoxicants whether prior to or during your Coverage Period.
    • any medical condition arising during your Coverage Period, from or in any way related to, the abuse of alcohol, drugs or other intoxicants.
  8. any loss resulting from your minor mental or emotional disorder.
  9. any non-emergency, investigative, experimental or elective treatment such as cosmetic surgery, chronic care, rehabilitation including any expenses for directly or indirectly related complications.
  10. general health examinations or services
  11. prescription drugs or medicines, treatment, appliances or devices provided to monitor or maintain any pre-existing condition
  1. an emergency resulting from:
    • mountain climbing requiring the use of specialized equipment, including carabiners, crampons, pick axes, anchors, bolts and lead-rope or top-rope anchoring equipment to ascend or descend a mountain;
    • rock-climbing;
    • parachuting, skydiving, hang-gliding or using any other air-supported sporting device;
    • participating in a motorized speed contest including training activities; or
    • your professional participation in a sport, snorkeling or scuba-diving when that sport, snorkeling or scuba-diving is your principal paid occupation.
  2. any pregnancy that commences prior to the effective date:
    • your routine pre-natal or post-natal care;
    • your pregnancy, delivery, or complications of either, arising 9 weeks before the expected date of delivery or 9 weeks after.
  3. medical treatment or services provided to your child born during your Coverage Period.
  4. the provision of insured services to children under 30 days of age.
  5. an act of war or an act of terrorism when you are outside of Canada and covered under this insurance.
  6. a continuation of treatment or service first recommended or prescribed by a physician or health-care practitioner before the effective date of this policy or where such insured services were first initiated before the effective date of this policy or during the waiting period, or for holders of a valid multiple-entry visa issued by the Government of Canada, during a return to your country of origin during the Coverage Period.
  1. your medical or health assessment or any form of report or document supporting an application to obtain immigrant status or extend your visa in Canada or any recommended treatment resulting from such health assessment.
  2. any medical treatment or follow-up visit outside of Canada when the emergency occurred in Canada.
  3. any emergency that occurs or recurs after our medical advisors recommend that you return to your country of origin and you choose not to. (See Loss of Coverage under Section 8 – General Conditions.)
  4. the ongoing treatment, recurrence or complication of a medical condition when you have already received emergency treatment for that condition during your Coverage Period and our Assistance Centre determines that your medical emergency has ended. (See 90-Day Provision (Reinstatement of Coverage) for exception.)
  5. any medical condition you suffer or contract in a specific country, region or city outside of Canada, while covered under the “Side-Trips Outside of Canada” provision or while on an uninterrupted flight to or from Canada if a Government of Canada Travel Advisory, issued before you travel to that location, advises to Avoid non-essential travel to or Avoid all travel to that specific country, region or city. In this exclusion, medical condition is limited, related or due to the reason for the Travel Advisory.
  6. any medical treatment for which you are eligible and/or covered under a government health insurance plan.
  7. covered expenses that exceed 80% of those we would normally pay, if you do not contact the Assistance Centre within 24 hours of hospitalization unless your medical condition makes it impossible for you to call. If your medical condition makes it medically impossible for you to call, someone must call on your behalf.
  8. any expenses arising from any sickness, disease, symptom or injury that presented, recurred or for which treatment was received during any suspension of coverage during a Side-Trip Outside of Canada.

Note: Each time you purchase another policy from us, each new policy will have a new effective date even if you are continuing the same visit to Canada (or other country covered under the “Side-Trips Outside of Canada” provision).